undergraduate thesis
Melanoma - epidemiological analysis

Sonja Kanđera (2016)
University North
University centre Varaždin
Department of Biomedical Sciences
Metadata
TitleMelanom - epidemiološka analiza
AuthorSonja Kanđera
Mentor(s)Biserka Pigac (thesis advisor)
Abstract
Melanom je jedan od najzloćudnijih tumora kože. Nastaje iz pigmentnih stanica melanocita koji maligno alteriraju a imaju sklonost ranom limfogenom i hematogenom metastaziranju. Čini oko 5 % svih primarnih zloćudnih tumora kože, ali je odgovoran za oko 80 % svih smrtnih slučajeva kožnih tumora. Godišnje povećanje oboljelih je oko 7 %. U Republici Hrvatskoj godišnje se otkrije oko 580 novootkrivenih melanoma. Melanom nastaje na nepromijenjenoj koži ili iz prekursorskih lezija. Najčešće se javlja na koži, no može se javiti i na sluznicama, oku i u živčanom sustavu. Najveći maligni potencijal imaju divovski urođeni i displastični nevusi. Melanom je najčešće tamne boje, od smeđe do crne, no može biti i bez pigmenta. Melanom prolazi kroz tri faze rasta: melanoma in situ (faza pojave malignih melanocita u epidermisa), radijalna faza (označava fazu lateralnog širenja) i vertikalna faza (faza invazije dermisa). Prema kliničkim značajkama i histološkoj slici razlikujemo 4 najčešća tipa: površinsko šireći melanom - SSM, nodularni melanom - NM, lentigo maligna melanom - LMM i akralno lentiginozni melanom - ALM. Najčešći je površinsko šireći melanom s najvećom pojavnošću na leđima u muškaraca i na donjim udovima u žena. Klinički znakovi koji upućuju na sumnju na melanom su asimetričan oblik, nepravilni, nazubljeni ili izbrazdani rubovi, boja koja može varirati od svijetlosmeđe do tamnosmeđe, veličine obično veće od 6 mm. Prognoza melanoma je primarno povezana sa debljinom tumora (Breslow), postojanjem ulceracija te povećanim brojem mitoza. Prema relativnoj stopi petogodišnjeg preživljenja prognoza za 0-stadij ima 97 %, I-stadij ima 90-95 % / 75 %, IIA-stadij ima 80 % / 65 %, IIBstadij ima 72-75 % / 50-60 %, IIC-stadij ima 53 % / 44%, III-stadij ima 45 % a IV-stadij ima 10 % preživljenja. Kod udaljenih metastaza u IV stadiju ovisno o jednom ili više metastatskih sijela stopa preživljenja u jednoj godini se smanjuje. Ostali nepovoljni prognostički čimbenici su regresija dijela tumora, mikrosateliti, starija životna dob te muški spol. Terapija je uvijek radikalna kirurgija, 1-3 cm u zdravo. Ako se u regionalnim limfnim čvorovima dokažu metastaze, izvodi se i disekcija limfnih čvorova. Rana dijagnoza i edukacija ključ su uspješnog liječenja melanoma. Osobe koje imaju melanom ili rakom kože opterećenu obiteljsku anamnezu ili imaju displastični nevus sindrom (nakupine displastičnih nevusa) treba dermatološki pregledavati najmanje jednom godišnje.
Keywordsmelanoma pathohistology of melanoma sentinel lymph node melanoma prevention prognosis for melanomas
Parallel title (English)Melanoma - epidemiological analysis
Committee MembersJurica Veronek (committee chairperson)
Biserka Pigac (committee member)
Melita Sajko (committee member)
GranterUniversity North
Lower level organizational unitsUniversity centre Varaždin
Department of Biomedical Sciences
PlaceKoprivnica
StateCroatia
Scientific field, discipline, subdisciplineBIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Pathology
Study programme typeprofessional
Study levelundergraduate
Study programmeNursing
Academic title abbreviationbacc. med. techn.
Genreundergraduate thesis
Language Croatian
Defense date2016-12-07
Parallel abstract (English)
Melanoma is one of the most malignant skin cancers. It begins in the skin's pigmentproducing cells called melanocytes which undergo a malignant alteration and have tendency to metastasize both lymphatic and hematogenous. Melanoma accounts for 5% of primary skin cancers but is responsible for 80% of deaths from skin cancer. There are 580 new cases of melanoma diagnosed in Croatia each year. Melanoma can arise from normal appearing skin or in precursor lesions. It typically affects the skin but can also occur in mucous membranes, eyes and the nervous system. Giant dysplastic nevi present at birth have a very high potential to become malignant. The majority of melanomas are black or brown but can also be non pigmented. There are three stages of melanoma: melanoma in situ (in this phase melanocytes become malignant within the basal layer of the epidermis), the radial phase (considers the lateral expansion) and the vertical growth phase (with invasion into dermis). According to the clinical characteristics and histological picture there are 4 basic types of melanomas: superficial spreading melanoma – SSM, nodular melanoma – NM, lentigo maligna melanoma – LMM, and acral lentiginous melanoma – ALM. The most common is superficial spreading melanoma which is most likely to occur on the back in men and the legs in women. Clinical signs that may indicate melanoma are asymmetrical form, irregular, jagged or notched edges, colour that can vary from light to dark brown and a size usually larger than 6 mm in diameter. The prognosis for melanoma is closely related to tumor thickness, the presence of ulceration and the increase in mitotic rate. The 5-year relative survival rate is as follows: stage 0 - 97%, stage I – 90-95% / 75%, stage IIA – 80% / 65%, stage IIB – 72-75% / 50 – 60%, stage IIC – 53% / 44%, stage III – 45%, and stage IV – 10%. Depending on one or more distant metastases in stage IV, the survival rate after one year declines. Other unfavourable prognostic factors are the presence of regression, microsatellites, older age and male gender. Therapy is always radical surgery that cuts 1 to 3 cm in healthy tissue. If regional lymph node metastases are detected, lymph node dissection can be performed. Early detection of melanoma and education are keys to successful treatment. Individuals who are diagnosed with melanoma or have a family history of melanoma or dysplastic nevus syndrome (a large number of dysplastic nevi) should be dermatologically checked at least once a year.
Parallel keywords (Croatian)melanom patohistologija melanoma sentinel limfni čvor prevencija melanoma prognoza melanoma
Resource typetext
Access conditionOpen access
Terms of usehttp://rightsstatements.org/vocab/InC/1.0/
URN:NBNhttps://urn.nsk.hr/urn:nbn:hr:122:554078
CommitterJasna Kosić